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Alcohol Fuels Liver Disease in Those With HIV and Hepatitis C

WEDNESDAY, May 7, 2014 (HealthDay News) -- People infected with both HIV and hepatitis C are much more likely to develop advanced liver disease if they drink any alcohol at all, according to a new study.

Researchers analyzed data from thousands of participants in a Veterans Affairs study on aging and found the risk of advanced liver fibrosis increased overall with alcohol use but was especially striking in patients with both HIV and hepatitis C (co-infected patients).

The data included more than 700 people who were infected with both HIV and hepatitis C, more than 1,400 infected with HIV only, nearly 300 infected with hepatitis C only, and nearly 1,160 uninfected people.

Among the study participants who were light drinkers, co-infected patients were 13 times more likely than non-infected people to have advanced liver fibrosis. Among participants who were heavy drinkers, co-infected patients were 21 times more likely than non-infected people to have advanced liver fibrosis.

The study was published online April 28 in the journal Clinical Infectious Diseases.

"The difference between co-infected and uninfected groups was stark. Given the prevalence of drinking in co-infected individuals, it is important to determine the patterns of alcohol use, such as nonhazardous drinking and even binge drinking, which are not traditionally thought to contribute to liver fibrosis," senior author Dr. Vincent Lo Re III, an infectious disease physician at the Veteran Affairs Medical Center in Philadelphia and an assistant professor of medicine and epidemiology at the University of Pennsylvania's Perelman School of Medicine, said in a university news release.

It's not clear why drinking increases the risk of advanced liver fibrosis in co-infected patients, but the researchers said preclinical studies have shown both viruses can induce liver cell death, and adding alcohol could accelerate that process. In addition, they noted, toxicity to the liver from antiretroviral drugs may also be exacerbated by alcohol.

The findings highlight "how important it is for clinicians to be counseling co-infected patients on reducing alcohol consumption. More communication and education about the risks of alcohol may prompt patients to reduce drinking or quit altogether, which will help reduce the incidence of complications," Lo Re said.